The Effect of Sevoflurane on Cardiac Output, Mean Systemic Filling Pressure, and Vascular Resistances in Children
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 40
- 试验地点
- 1
- 主要终点
- cardiac output
研究概览
简要总结
Cardiac output (CO) is measured using Mostcare. Mean systemic filling pressure (MSFP) and vascular resistances are calculated using venous return curves constructed by measuring steady-state arterial and venous pressures and cardiac output (CO) during inspiratory hold manoeuvres at increasing plateau pressures. Measurements are performed at three incremental levels of targeted sevoflurane concentrations.
详细描述
Tracheal intubation is performed after anesthesia induction with sevoflurane. Radial arterial is cannulated and pressure transducer is connected to MostCare (core technique PRAM). HR, MAP, CVP, CO, SVR, PPV, and dp/dt are recorded at three incremental levels of targeted sevoflurane concentrations. MSFP and vascular resistances are calculated.
研究设计
- 研究类型
- Observational
- 观察模型
- Cohort
- 时间视角
- Prospective
入排标准
- 年龄范围
- 3 Years 至 10 Years（Child）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •American Association of Anesthesiologists (ASA)physical status score I-III
- •major elective surgery that dictates the use of invasive hemodynamic monitoring including CVP and continuous arterial blood pressure monitoring.
排除标准
- •symptomatic peripheral vascular disease or pulmonary disease
- •aberrant cardiovascular anatomy
- •significant valvular regurgitation
- •severe arrhythmia
结局指标
主要结局
cardiac output
时间窗: Hemodynamic parameters are recorded after 15 min of equilibration at each sevoflurane concentration.
Cardiac output is monitored using Mostcare via a radial arterial catheter connected to the pressure transducer.
mean systemic filling pressure
时间窗: Hemodynamic parameters are recorded after 15 min of equilibration at each sevoflurane concentration.
Mean systemic filling pressure (MSFP) is calculated using venous return curve constructed by measuring steady-state arterial and venous pressures and CO during inspiratory hold manoeuvres at increasing plateau pressures. The CVP and CO data are fitted by linear regression to define the venous return curve. We define MSFP by extrapolation to zero flow.
vascular resistance
时间窗: Hemodynamic parameters are recorded after 15 min of equilibration at each sevoflurane concentration.
Total systemic vascular resistance (Rsys) is calculated as the ratio of the pressure difference between mean Pa and mean CVP and CO. The resistance downstream to MSFP is taken to reflect the resistance to venous return (Rv) and is calculated as the ratio of the pressure difference between MSFP and CVP and CO. Systemic arterial resistance (Ra) is taken to be the difference between systemic and venous resistance.
次要结局
- mean arterial pressure(Hemodynamic parameters are recorded after 15 min of equilibration at each sevoflurane concentration.)
- central venous pressure(Hemodynamic parameters are recorded after 15 min of equilibration at each sevoflurane concentration.)
- pulse pressure variation(Hemodynamic parameters are recorded after 15 min of equilibration at each sevoflurane concentration.)
- dP/dt(Hemodynamic parameters are recorded after 15 min of equilibration at each sevoflurane concentration.)